Brandon Stavish

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02196 Issued in MN

Practice address

1321 13TH St N
Saint Cloud, MN 56303-2613

Phone

(320) 202-2060

NPI assigned

Aug 12, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Central Minnesota Mental Health CenterGroup PAC ID 4486555877, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Law

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Minnesota Mental Health Center

  • Mental Health Counselor
  • Saint Cloud, MN
  • NPI 1831177195
  Medicare reassignment Care Compare group NPD
• Central Minnesota Mental Health Center

  • Counselor
  • Saint Cloud, MN
  • NPI 1053576546
  NPD
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1508412925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 13TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032613",
            "telephone_number": "320-202-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 13TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032613",
            "telephone_number": "320-202-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVISH",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Kaye Stark Davis, PHARMD
• Rose Melinda Stark-Rose, PHD
• Steven Daniel Stasiewicz, NURSE PRACTITIONER
• Statewide Medical Transportation
• Joseph E Stattine, RPH
• Jerome John Stawarski
• STCH St Cloud LLC
• Stearns County
• Brooke M Steckelberg
• Loretta Theresa Steckelberg, LICSW

• Mental Health Counselor in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.